1/299. Acinic cell carcinoma of the lung with metastasis to lymph nodes.A 64-year-old man presented with an asymptomatic left lower lobe mass. At bronchoscopy there was a tumor in the superior segment. biopsy revealed an acinic cell carcinoma. There was no evidence of salivary gland or other site of origin. Lobectomy and lymph node staging showed involvement of interlobar (N1) nodes, while higher stations were benign. The patient remains well 20 months postoperatively. This is the only instance of primary pulmonary acinic cell carcinoma with lymph node metastasis among 15 cases in the literature. We review the clinical features, histology, and treatment of the reported cases.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/299. Long-term survival after extended surgical resection of melanoma metastasis and immunotherapy.A patient with a huge melanoma metastasis to the left adrenal gland was treated by multivisceral surgical resection. Progression of disease could be controlled by systemic immunotherapy resulting in long-term survival. In selected cases, above all with late manifestation of distant melanoma metastases, even major surgical resection of such lesions can be worthwhile.- - - - - - - - - - ranking = 1.9397062208394keywords = gland, adrenal gland, adrenal (Clic here for more details about this article) |
3/299. Surgical treatment for recurrent tumors of primary malignant melanoma of the esophagus: a case report and review of the literature.The purpose of this communication is to present a case of resection performed for local recurrent tumors of primary malignant melanoma of the esophagus (PMME) and to review the relevant literature. The patient was a 54 year-old man who had received an intraabdominal esophagectomy with a total gastrectomy for primary malignant melanoma of the abdominal esophagus in another hospital, in November 1995. After the initial operation, he was treated as an outpatient. In August 1997, computed tomography and ultrasonography revealed recurrent tumors in the dorsal pancreatic lymph node and in the right adrenal gland. The recurrent tumor of the dorsal pancreas directly invaded the dorsal pancreas parenchyma and occluded the superior mesenteric vein and splenic vein, and the other metastatic tumor in the right adrenal gland existed in the absence of circumference invasion. Metastases of the PMME were confirmed in the dorsal pancreas, the superior mesenteric vein, splenic vein, and right adrenal gland, and were removed by a total pancreatectomy on October 7, 1997. By immunohistochemical staining, we found that the focal areas expressed S-100 protein and HMB-45 antibody. Currently (February 1998), the patient is alive and disease-free. PMME is an extremely rare tumor with a poor prognosis for survival. Only 2 cases of removal of recurrent tumors, including the present case, have been reported. The treatment of choice is surgical resection, even in cases of recurrence, because radiotherapy and/or chemotherapy have not been proven to be beneficial; however, they may play a palliative role if surgery is not possible.- - - - - - - - - - ranking = 5.8191186625182keywords = gland, adrenal gland, adrenal (Clic here for more details about this article) |
4/299. Unilateral aneuploid dedifferentiated acinic cell carcinoma associated with bilateral-low grade diploid acinic cell carcinoma of the parotid gland.A dedifferentiated acinic cell carcinoma (AciCC) of the right parotid gland with lymph node metastases occurred in a 36-year-old woman. The tumour was associated with a bilateral well-differentiated AciCC. The two components of this tumour had different (high and low) proliferative activity measured by Mib-1 and different (aneuploid and diploid) dna content. Despite the presence of a high-grade component, TP53 mutations, microsatellite instability (MSI) and/or loss of heterozygosity (LOH) at the p53 locus were not detected. Although the follow-up of the patient is very short, the aggressiveness of the tumour is shown by a recurrence in the right parotid within 4 months and by the rapid development of regional metastases.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
5/299. A case of metastatic extramammary Paget's disease that responded to combination chemotherapy.Extramammary Paget's disease is considered to be a malignant tumor originating from the sweat glands. Some cases of extramammary Paget's disease infiltrate the dermis and metastasize to the regional lymph nodes. No standard treatment has been established for advanced cases. Few previous studies of the treatment for metastatic Paget's disease have revealed an effective regimen. The prognosis of metastasized cases is very poor. We encountered a patient in whom extramammary Paget's disease had metastasized to the lymph nodes beyond the regional lymph nodes and systemic chemotherapy was partially effective. Combination chemotherapy consisted of mitomycin C 3.5 mg/m2 and epirubicin 50 mg/m2 on day 1, vincristine 0.6 mg/m2 on days 1 and 7, cisplatin 30 mg/m2 from days 1 to 3, and 5-fluorouracil 350 mg/m2 from days 3 to 7. After two courses of chemotherapy, the metastatic lymph nodes decreased in size by more than 90% compared to that before chemotherapy. We defined the treatment effect of this regimen as a partial response (PR). Microscopic examination of the resected lymph nodes revealed replacement of metastatic lesions by fibrous tissue, suggesting a therapeutic effect. anorexia, alopecia, and leukopenia (neutropenia) have been reported as toxicities, but all were tolerated. Our results may provide useful indications for the management of this tumor. This particular combination chemotherapy is recommended for extramammary Paget's disease patients with systemic nodal metastases.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/299. Gastric cancer with sarcoid reactions in the regional lymph nodes, the stomach wall, and the splenic parenchyma: report of a case.A 66-year-old man was referred to our institute for investigation of heartburn and epigastralgia. Endoscopic examination demonstrated a type 4' gastric cancer which occupied the whole stomach. At laparotomy, multiple small nodules were found in the spleen which were diagnosed as metastases of the gastric cancer. Thus, total gastrectomy with distal pancreatectomy, splenectomy, cholecystectomy, and left adrenalectomy, combined with D4 lymph node dissection, was performed. Microscopic examination of the tumor revealed tubular and mucinous adenocarcinoma which invaded the muscularis propria. Sarcoid reactions were observed in the submucosa adjacent to the carcinoma tissue. Only one lymph node from station no. 8a demonstrated tumor metastasis, while those from station nos. 1, 2, 7, 8, 9, 10, 11, 13, and 16 revealed sarcoid reactions without tumor metastases. Subsequently, the multiple small nodules that had been presumed to be splenic metastases at laparotomy were found to be sarcoid reactions similar to those seen in the submucosa and regional lymph nodes. Since no skin or ocular lesions indicative of systemic sarcoidosis were seen in this patient, a diagnosis of advanced gastric cancer associated with sarcoid reactions was established. To our knowledge, there have been no previous reports regarding an association between sarcoid reactions in the spleen and gastric cancer.- - - - - - - - - - ranking = 0.14041895909054keywords = adrenal (Clic here for more details about this article) |
7/299. Metastasizing porocarcinoma of the head with lethal outcome.Porocarcinoma is a very rare malignant tumor arising from the duct of eccrine sweat glands. Its prognosis is variable. We report on a patient who developed lymph node and multiple distant metastases, and who died of this malignancy only 6 months after the initial diagnosis.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/299. Thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst.A case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst is described. A 46-year-old woman presented with a 2.0 x 2.0 cm mass in her left lateral neck. The excised mass showed a cystic lesion with a thyroid papillary carcinoma. Following a lateral cervical cystectomy, subsequent thyroid gland and lymph nodes dissections were performed. Pathological examination showed an adenomatous goiter and no primary carcinoma in the thyroid gland, as well as metastatic papillary carcinoma in the lymph nodes. Two cases of thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cyst have been reported previously, but no lymph node metastases were recognized. The first case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst, and accompanied by lymph node metastasis is presented.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
9/299. Mediastinal lymph node involvement as the initial manifestation of occult thyroid cancer in the surgical treatment of lung cancer: report of a case.A 63-year-old man was referred to our institute for the treatment of squamous cell carcinoma of the upper lobe of his right lung. A right upper lobectomy of the lung was performed with a mediastinal lymph node dissection. The postoperative pathological examination of the dissected specimens revealed one of the superior mediastinal lymph nodes to be morbid with micrometastasis of occult thyroid cancer, while no node involvement was seen due to lung cancer. A right lobectomy of the thyroid gland with a modified radical neck dissection was done 4 years later after the confirmation of the absence of any recurrent sign of lung cancer. In the resected specimen, papillary thyroid microcarcinoma was observed with several intraglandular metastases and right regional lymph node involvement. Eight months later, a new primary lung cancer developed in the left lung, and a left upper lobectomy of the lung with a mediastinal lymph node dissection was performed. At that time, the absence of mediastinal lymph node metastasis from lung cancer or thyroid cancer was confirmed. Mediastinal lymph node involvement as the initial manifestation of occult thyroid cancer in surgical treatment for lung cancer is rare, but it is important to be aware of the possibility of incidentally detecting occult thyroid cancer in surgical dissections in this area for lung cancer. The appropriate surgical treatment should be determined while carefully considering the prognosis of the lung cancer as well as that of any coexisting malignancy.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
10/299. Rectal adenocarcinoid with lymph node metastasis.We describe a case of a rare variant of a rectal carcinoid tumor that showed mucous gland differentiation accompanied by a lymph node metastasis with a histological appearance similar to that of the primary site. The tumor consisted of a typical argyrophilic carcinoid component and of goblet cell glands. The carcinoid component was positive for neuron-specific enolase, chromogranin a and synaptophysin. The goblet cells stained positively with periodic acid-Schiff (PAS) and alcian blue, and expressed carcinoembryonic antigen, but were negative for neuroendocrine markers. This case suggests that carcinoid tumor can differentiate towards mucus glands, which can also be found in the metastatic site.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
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